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Quality of life in Parkinson’s disease improved by apomorphine pump: the OPTIPUMP cohort study

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Abstract

To report on OPTIPUMP, a cohort study, investigating the impact in real-life clinical settings of continuous subcutaneous apomorphine infusion (CSAI) on the quality of life (HRQoL) of patients with Parkinson’s disease. OPTIPUMP was a prospective, open-label, observational cohort study involving 30 investigational sites in France. CSAI was proposed as part of routine clinical care to patients aged ≥18 years, in absence of dementia, with a PD diagnosis and based on the presence of motor fluctuations not controlled by oral treatments. The impact of APO-pump on quality of life was evaluated as the difference in PDQ-39 scores between the initiation treatment and the follow-up visit after 6 months’ treatment. All adverse events were recorded. Hyper- and hypodopaminergic behavioral tolerance was assessed on the Ardouin Scale of Behavior in Parkinson’s Disease. Between September 2011 and January 2013, we enrolled 142 patients: 42 patients were withdrawn due to pump removal (33), death (4), lost of follow-up (4), no available data (1). 100 completed the study. At 6 months, their HRQoL had significantly improved (p = 0.011), as had their total UPDRS score (p < 0.001). Regarding the safety profile, Ardouin scale scores indicated that their hyperdopaminergic behaviors had not increased. CSAI had a favorable impact on HRQoL, with benefits outweighing risks. The analysis of the withdrawn patients highlights the heterogeneity of the use of the pump having an impact on its efficacy and tolerability.

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Acknowledgments

The authors are indebted to Sébastien Woynar for his experienced participation in the organization of the study and technical support, Sara Calmanti for critical readings, manuscript editing and submission, and Elisabeth Portier for advice in manuscript editing.

Sophie Arguilliere, Stéphanie Bannier, Philippe Busson, Valérie Chauvire, Théodor Danaila, Pascal Derkinderen, Anne Doe De Maindreville, Frédérique Fluchere, Eric Gaujard, Julien Gere, Olivier Ille, Paul Krack, Pierre Krystkowiak, Amélie Leblanc, Romain Lefaucheur, Alain Legout, David Maltete, Fabienne Ory, Aurélia Poujois, Nicolaîe Rasvan Gosporady, Alain Razafindramboa, Anne Salmon, François Tison, Fréderic Torny, Tatiana Witjas, Farid Yekhlef, Fabienne Zaetta.

Author information

Authors and Affiliations

  1. Department of Neurology, EA 4712, University Rennes 1, CHU Pontchaillou, 2 Henri Le Guilloux, 35000, Rennes, France

    Sophie Drapier & Marc Vérin

  2. Department of Neurology and Movement Disorders, APHM Timone University Hospital and Institut de Neurosciences de la Timone, AMU-CNRS UMR 7289, Marseilles, France

    Alexandre Eusebio & Jean Philippe Azulay

  3. Department of Neurology, Centre Expert et Inter-Régional de Coordination de la Maladie de Parkinson, Hôpital de la Pitié-Salpêtrière, APHP, 47-83 boulevard de l’Hôpital, 75013, Paris, France

    Bertrand Degos

  4. Department of Movement Disorders and Neurology, CHU Clermont-Ferrand, 58 rue Montalembert, 63003, Clermont-Ferrand, France

    Franck Durif

  5. Department of Neurology, University Hospital, Avenue des Tamaris, 13616, Aix-En-Provence, France

    François Viallet

  6. Department of Neurology, CHU Nantes, boulevard Jacques-Monod-Saint-Herblain, 44093, Nantes, France

    Tiphaine Rouaud

  7. Department of Movement Disorders and Neurology, INSERM U1171, Lille University, CHU Lille, 2, avenue Oscar Lambret, 59037, Lille, France

    Caroline Moreau & Luc Defebvre

  8. Department of Psychiatry and Neurology, CHU Grenoble, Avenue Maquis du Grésivaudan, 38700, La Tronche, France

    Valerie Fraix

  9. Department of Movement Disorders and Neurology, CHU Strasbourg, 1 Place de L Hôpital, 67000, Strasbourg, France

    Christine Tranchant

  10. CLINACT Groupe, Sèvre, France

    Karine Andre

  11. Department of Clinical Pharmacology and Neurosciences, UMR 825 Inserm, University Hospital Toulouse III, 31059, Toulouse, France

    Christine Brefel Courbon

  12. Department of Neurology, Assistance Publique Hôpitaux de Paris, Inserm, U 1127, CNRS, UMR 7225, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Sorbonne Universités, 47-83 boulevard de l’Hôpital, 75013, Paris, France

    Emmanuel Roze

  13. Department of Medical Pharmacology, INSERM U1171, Lille University, CHU Lille, 2, avenue Oscar Lambret, 59037, Lille, France

    David Devos

  14. Neurology Department, University Hospital, 2 rue Henri Le Guilloux, 35200, Rennes, France

    Sophie Drapier

Authors
  1. Sophie Drapier
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  2. Alexandre Eusebio
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  3. Bertrand Degos
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  4. Marc Vérin
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  5. Franck Durif
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  6. Jean Philippe Azulay
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  7. François Viallet
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  8. Tiphaine Rouaud
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  9. Caroline Moreau
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  10. Luc Defebvre
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  11. Valerie Fraix
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  12. Christine Tranchant
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  13. Karine Andre
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  14. Christine Brefel Courbon
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  15. Emmanuel Roze
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  16. David Devos
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Corresponding author

Correspondence to Sophie Drapier.

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Study funding

The study has been funded by Orkyn’ and Aguettant.

Conflicts of interest

Dr Sophie Drapier received speech honorarium from Teva and Medtronic; and served on scientific advisory boards for Aguettant and Britannia. Dr Alexandre Eusebio received honoraria from UCB, GE Healthcare, Aguettant, is in the advisory board for Orkyn and has received research grants from the French Ministry of Health and the Agence Nationale de la Recherche. Dr Bertrand Degos received research support from INSERM (COSSEC), patient’s association France Parkinson; received travel fundings from Novartis, Teva, Lundbeck, MERZ-pharma; received speech honorarium from Novartis and Medtronic; and served on scientific advisory boards for Aguettant. Dr Marc Vérin has served on the Scientific Advisory Board for Aguettant and Orkyn and received speech honorarium from Teva and Medtronic. Dr Franck Durif has served on the Scientific Advisory Board for Aguettant and Orkyn and received speech honorarium from Teva and Medtronic. Dr Jean Philippe Azulay received honoraria from Abbvie, Boehringer, UCB and is in the advisory board for Abbvie, Zambon, UCB. Dr François Viallet has served on the Scientific Advisory Board for Aguettant and Orkyn. Dr Tiphaine Rouaud received speech honorarium from Teva. Dr Caroline Moreau has served on the Scientific Advisory Board for Aguettant. Dr Luc Defebvre served on the Scientific Advisory Board for Novartis, Aguettant and Abbvie, and has received various honoraria from pharmaceutical companies (Abbott Abbvie and Boehringer) for consultancy and lectures on Parkinson’s disease at symposia. Dr Valerie Fraix received honorarium from Medtronic France. Dr Christine Tranchant received speech honorarium from Teva and served on scientific advisory boards for Allergan and Abbvie. Karine Andre reports no disclosure. Dr Christine Brefel Courbon served on the Scientific Advisory Board for Novartis, Aguettant, UCB, Medtronic and received PHRC grants from the French Ministry of Research. She has received various honoraria for consultancy and lectures at symposia from pharmaceutical companies. Dr Emmanuel Roze is the recipient of a grant “poste d’accueil” AP-HP/CNRS. He received research support from INSERM (COSSEC), AP-HP (DRC-PHRC), Fondation pour la Recherche sur le Cerveau (FRC), Merz-Pharma, Orkyn, IP santé, Ultragenyx; served on scientific advisory boards for Orkyn, Ultragenyx and Merz-pharma; received speech honorarium from Merz-pharma, Novartis, Ipsen-Pharma and Orkyn, received travel funding from Ipsen-Pharma, Teva, Abbvie, Merz-Pharma, Dystonia Europe, the Georgian Medical and Public Health Association the International Federation of Clinical Neurophysiology, and the Movement Disorders Society. Dr David Devos served on the Scientific Advisory Board for Novartis and Aguettant and has received PHRC grants from the French Ministry of Health and research funding from the ARSLA charity. He has received various honoraria from pharmaceutical companies for consultancy and lectures on Parkinson’s disease at symposia.

Additional information

OPTIPUMP Study Group. Members of the OPTIPUMP Study Group are present in Acknowledgements.

Electronic supplementary material

Below is the link to the electronic supplementary material.

415_2016_8106_MOESM1_ESM.docx

Supplementary Fig. 1. Treatment changes during the study (DOCX 34 kb)

415_2016_8106_MOESM2_ESM.docx

Supplementary Fig. 2. UPDRS scores at baseline and 6 months after CSAI initiation (DOCX 26 kb)

415_2016_8106_MOESM3_ESM.docx

Supplementary Table 1. Apomorphine doses and rates between CSAI initiation and 6-month follow up (DOCX 17 kb)

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Drapier, S., Eusebio, A., Degos, B. et al. Quality of life in Parkinson’s disease improved by apomorphine pump: the OPTIPUMP cohort study. J Neurol 263, 1111–1119 (2016). https://doi.org/10.1007/s00415-016-8106-3

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